The Foods You Eat And Stroke Risk

Depending on what you normally eat (your dietary pattern), you can either increase your risk for strokes or can decrease your risk. It's up to you.

A large European study involving 9 countries and 418,329 persons found that regularly eating greater amounts of fruits, vegetables, fiber (from foods), milk, cheese, and yogurt were each linked to a lower risk of ischemic stroke. But not hemorrhagic stroke. However, hemorrhagic stroke was associated with a greater consumption of eggs.

The great majority of strokes are ischemic strokes, which occur when an artery in the brain becomes blocked. [Fatty deposits lining the vessel walls, called atherosclerosis, are the main cause.] Hemorrhagic strokes are due to leaking or bursting of a blood vessel in the brain.

On average, participants who developed an ischemic stroke reported lower intakes of cheese, cereals and cereal products, fruit and vegetables, legumes, nuts and seeds, but higher intakes of red and processed meat. [NOTE: Once again a diet rich in fruits, vegetables, whole grains, seeds, nuts is best. Think Mediterranean style dietary pattern.]

Unfortunately, the participants in the study only answered one lifestyle and food questionnaire (asking about their usual diet) at the start of the study, after which they were followed for 12.7 years. The thinking is that people tend not to change how they eat over time. (But is that true for everyone?)

Looking at the study details, I unfortunately did not see any mention of highly processed foods, or oils (vegetable, canola, corn, palm, olive, etc). There is a lot of excitement right now about extra virgin olive oil being healthy, anti-inflammatory, and "protective" for a number of diseases.

Different types of food are linked to risks of different types of stroke, according to the largest study to investigate this, published in the European Heart Journal today.

The study found that while higher intakes of fruit, vegetables, fibre, milk, cheese or yogurt were each linked to a lower risk of ischaemic stroke, there was no significant association with a lower risk of haemorrhagic stroke. However, greater consumption of eggs was associated with a higher risk of haemorrhagic stroke, but not with ischaemic stroke.

Ischaemic stroke occurs when a blood clot blocks an artery supplying blood to the brain or forms somewhere else in the body and travels to the brain where it blocks blood flow. Haemorrhagic stroke occurs when there is bleeding in the brain that damages nearby cells. About 85% of strokes are ischaemic and 15% are haemorrhagic. Stroke is the second leading cause of deaths worldwide.

Dr. Tammy Tong, the first author of the paper and a nutritional epidemiologist at the Nuffield Department of Population Health, University of Oxford (UK), said: "The most important finding is that higher consumption of both dietary fibre and fruit and vegetables was strongly associated with lower risks of ischaemic stroke, which supports current European guidelines. The general public should be recommended to increase their fibre and fruit and vegetable consumption, if they are not already meeting these guidelines.

The total amount of fibre (including fibre from fruit, vegetables, cereal, legumes, nuts and seeds) that people ate was associated with the greatest potential reduction in the risk of ischaemic stroke. Every 10g more intake of fiber a day was associated with a 23% lower risk, which is equivalent to around two fewer cases per 1000 of the population over ten years.

Fruit and vegetables alone were associated with a 13% lower risk for every 200g eaten a day, which is equivalent to one less case per 1000 of the population over ten years. No foods were linked to a statistically significant higher risk of ischaemic stroke.

Based on UK estimates, two thick slices of wholemeal toast provide 6.6g of fibre, a portion of broccoli (around eight florets) provides about 3g, and a medium raw, unpeeled apple provides about 1.2g of fibre. The European Society of Cardiology (ESC) and the World Health Organization Regional Office for Europe recommend consuming at least 400g of fruit and vegetables a day; the ESC also suggests people should consume 30-45g of fibre a day.

The researchers found that for every extra 20g of eggs consumed a day there was a 25% higher risk of haemorrhagic stroke, equivalent to 0.66 extra cases per 1000 (or around two cases per 3000) of the population over ten years. An average large-sized egg weighs approximately 60g. Egg consumption in the EPIC study was low overall, with an average of less than 20g eaten a day.

Dr. Tong and her colleagues analysed data from 418,329 men and women in nine countries (Denmark, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden and the United Kingdom) who were recruited to the European Prospective Investigation into Cancer and Nutrition (EPIC) study between 1992 and 2000. The participants completed questionnaires asking about diet, lifestyle, medical history and socio-demographic factors, and were followed up for an average of 12.7 years. During this time, there were 4281 cases of ischaemic stroke and 1430 cases of haemorrhagic stroke.